We woke up on Tuesday feeling a little apprehensive about the day ahead. The bus ride the day before had disheartened everyone a bit, especially Eliza who unfortunately had been sick for the whole ride. We got up around 8 and went to a place called April’s where we were served much the same as in Siuna: plantains, rice, beans and some chicken for a meal. It was interesting that it seemed this was the staple meal for pretty much all of la RAAN. I definitely couldn’t complain though; it was delicious!

From breakfast we split up into two groups for the morning. Juan and Eliza went to the UN Program Development meeting while Phil, Annie, and I went to check out the domestic violence shelter in Bilwi. Eliza and Juan had a decent time at the meeting; Eliza met a person from Finland who could speak both English and Spanish perfectly, which she found to be very impressive. Unfortunately they went back to the hotel early because she was still feeling a bit under the weather. Our time with the shelter though was very productive! We talked with Shira, the programs director at the shelter about the basic function of the shelter, the problems they’ve encountered, and how they have dealt with it all over the years. This sort of feedback helped us develop a comprehensive plan for our own shelter and some basic preparations for its inauguration, which made the shelter tour invaluable.

After meeting with Shira we took Karen Thompson out to lunch! She is the director of Salud Sin Limites in all of Nicaragua and she works in partnership with the Movement for Women, which operates the shelter directly. We talked about the domestic violence in Bilwi and how it related to domestic violence in the U.S. Afterwards, we met up with Juan and Eliza and decided to go to the beach for a while in the afternoon. There are several pictures of our handiwork on the blog, but for those of you who haven’t checked them we made a giant GlobeMed banner in the sand!

Juan then led us the Casa Museo, which was really cool because we got to learn all about all the different customs in Bilwi. For example, the Garifonas were originally slaves from Africa, eventually they became to be freed peoples. However most of them either continue to speak their language or a form of it as well as celebrate religions that originate from Africa. So it’s almost like Nicaragua has a little piece of Africa in its own backyard!

However the best part of the day was yet to come for me at least. We got the chance to go back to the shelter and play with the children staying there. It was tons of fun to get to interact with the children and to see that despite all that they had been through and their current situation, they still could laugh and play just the same as any other child! It was an impressive display of resilience from these victims, and it made me reconsider the way I viewed children who were victims of such abuse.

Finally we went out to dinner with Karen Thompson again, and she regaled us with how she came to work for SSL and what her plans were for the future. Altogether it was a great day, and going to the shelter, finding out information about it, and playing with the kids there made the trip completely worth it. Meeting Karen was amazing; she had so much advice and it was tremendously reassuring to know the head of SSL in Nicaragua was so competent and involved with the community! Though the trip there was hard on all of us, the information we gleaned from everything was absolutely essential and provided a unique perspective on the project we ourselves were undertaking.

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Discussing Next Project: Salud Sin Límites Knows Best

It is very interesting how non-governmental organizations (NGOs) pick their projects in Siuna, Nicaragua. Actually, I would bet that most NGOs around the world, including NGOs in ‘The West’ function as so: the focus of the NGO is not always driven by the best interests of the community but rather by the donors’ interests. Why do I say this? Well, lately we have been talking with Juan, our main contact, about our next project with Salud Sin Límites (SSL), and it has been hard to pry out of him what SSL thinks is best for the community. He told us that they have never really gotten the chance to think about it. They have always had a criteria to meet or a funder to appease. They have managed to maintain the overall focus of SSL while working with other funders, but they haven’t been able to give their opinion 100 percent, whereas we as an organization want to fund exactly what project SSL wants to implement. We reminded Juan that GlobeMed was different from other donors in this way. As GlobeMed, we want to sufficiently reach the needs of the Siuna community in the most sustainable way. And we recognize that SSL, an organization significantly integrated with the Siuna community, knows the best way how to do that because they understand the priorities of the community much better than we ever could. Eventually, Juan did tell us what projects SSL thought would be most effective in the community, but it was curious how long it took him to disregard our opinion for the sake of the conversation.

I wish more donors understood that community organizations, like SSL know their community best. Donors can be so wasteful with their money sometimes: thousands of dollars might go to buy food, which is good, but its temporary. And if the food is imported to the community from an outside source, the community farmers and other food producers could go out of business. This is just one example of how ineffective foreign aid can be. If the donor does not listen to the community, the money will most likely go to waste. If donors were more interested in learning about the community’s needs, and working with one or more community leaders, the health and general development of lower-income communities globally could potentially improve dramatically.

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Developing the New Project

Over the past couple of days, we have been brainstorming with Juan to plan our next project. As of right now, Salud Sin Limites has 2 major projects, one of which is the shelter and the prevention of domestic violence. The second area of focus is prevention of HIV through a partnership with the Ministry of Health. Salud Sin Limites aims educate the community on the disease and the partnership with the ministry of health allows testing and treatment. Salud Sin Limites is directly responsible for the education part, and every Saturday they have a radio program where teenagers talk about HIV.  We actually got to be on the program today as special guests! MINSA is in charge of the testing and treatment. We wanted to see how we could get involved so after talking to Juan about the program Salud Sin Limites already had going, we set up a meeting with the Ministry of Health to see how we could help. Although HIV is present in the community and education about prevention is undoubtedly important, the scope of the problem is largely unknown because of the lack of resources for testing. Presently, there are only a few documented cases in Siuna of HIV but there’s a good chance that this is because not many people have been tested, therefore it’s possible that HIV is more of a problem here than the numbers indicate. So, after meeting with MINSA, (Ministry de salud) and talking with Juan, we have decided that through the already established partnership of Salud Sin Limites and MINSA, we will be funding the purchase of HIV tests for the community, as well as funding educational programs already in existence, such as the weekly radio program. One HIV test costs 1.45 cordobas, which is equivalent to 6 cents! Hopefully with these testing materials, the community of Siuna will be able to benefit both from increased awareness of the prevalence of HIV and earlier access to treatment for those who test positive.

Our meeting with MINSA indicated the need for HIV tests but they also provided us with a list of other health priorities for the community. Many items on the list addressed the problem of cervical cancer from a variety of different steps, from testing to treatment. We asked Juan if this was something he wants Salud Sin Limites to be involved in in the future and he said yes, we could partner with MINSA to create educational programs about cervical cancer and getting tested routinely, while also funding the tests and the equipment needed to treat cervical cancer. The education part will probably involve radio programs similar to the programs currently used for education on HIV. Since the purpose of GlobeMed and GROW is to design projects that best meet the needs of the community, we are all really excited about addressing this problem that clearly needs attention!

So, our goal for next year will now be working towards a variety of programs that fall under the common theme of “Improving Women’s Health”, by continuing our involvement of the domestic violence shelter, getting involved with the HIV program, and helping Salud Sin Limites to start a new program targeting the prevention and treatment of cervical cancer. We are working out more details with Juan tomorrow to establish a more concrete plan but that’s what we have so far. Pretty exciting that our partnership with Salud Sin Limites is expanding!

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Week 3: Typical Day in Siuna

It’s our last full week in Nicaragua and the GROW team minus Eliza sitting here in our little technology corner of Juan’s living room, all in our respective chairs with our laptops, as it rains outside (again…. it rains every day in the winter!), is a typical scene after a work day. It’s been an eventful week! We’ve made a significant amount of progress on the fence and I feel like we have gotten to experience some of the most exciting elements of Nicaraguan culture this week, especially with celebration of Mother’s day, a huge holiday here.

Our typical day this week began with breakfast at Juan’s house and heading over to the shelter around 9 and doing whatever we could with the construction of the fence for a few hours. This is when my talents as a metal worker (or lack thereof) were showcased. Eliza and I learned how to make these metal squares out of wire, probably about 5×5 inches, each worth approximately one cordoba! I think Dan, Phil, and Juan have explained the function of these metal squares to me at least three times each, but to be honest, the extent of my knowledge is that they are somehow supporting the fence, which is enough for me! They probably aren’t even called metal squares. Anyway, Phil made some metal squares too but mostly the boys were digging holes and taking out posts and unloading heavy stuff from the trucks. Eliza and I would also go with Juan during the day to get quotes on the prices of the beds or kitchen items and figure out when all of our supplies would be delivered to the shelter. We would go out for lunch every day with Juan and then in the afternoon, return to the Salud Sin Limites office, work on the shelter more, or have meetings. We also went to a couple festivals for Mother’s day, which included a traditional dance performance, something like a community fair with games and prizes, and a fashion show. On Friday, we visited Inatec, the local university, again to help Sebastian teach his English classes. Everyone is really friendly and I feel like getting to know some of the students has given us more of a presence in the community. Plus, it’s always nice to see familiar faces if we are out walking around or at a soccer game or one of the festivals.  We’ve also had some pretty competitive games of “Yuker” even though Dan and I have yet to win (must be rigged) and we taught Juan and Shellda “Rummy,” which was fun too.

So that’s a general idea of what our days have been like this week! Since tomorrow is our last full day, we are thinking about going to a ranch with Juan and his family or possibly going swimming in the river again. It should be a good time!

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Pleasantly Surprised

The community in Siuna is much more supportive than I had ever imagined. Before arriving, I only thought that Salud Sin Límites, the Women’s Commission, and the Mayor were involved. I wasn’t expecting any other help from other organizations, other parts of the government, nor from most of the community members. Matter of fact, I thought the GROW team and I were going to have trouble fitting into the community and making friends because our work was related to what I thought was a very uncomfortable topic. However, the reality is completely different from what I once pictured. I think the rest of the GROW team would agree with me on this. Literally everyone is talking about domestic violence (DV) and everyone has at least heard of the future shelter. There was one moment in our first week onsite that really surprised me in how wrong my perception was of the community concern for DV. The team and I were walking down the street with the president of the Women’s Commission, Reina Flores, and then boom! Right in front of us was a mass of children painting a beautifully meaningful DV mural. The first thing I said was, “I didn’t even know the definition of domestic violence when I was the age of these kids.” The kids were middle school aged, and yet they were already engaged in the stand against DV. Coincidently, just yesterday the same kids showed up to the shelter to help us in our work to build a new fence.

One of the young boys was explaining the meaning of the mural to Eliza. In the mural, everything on the left side of the face is sad and broken, and everything on the right side of the face is cheerful and peaceful.

One of the young boys was explaining the meaning of the mural to Eliza. In the mural, everything on the left side of the face is sad and broken, and everything on the right side of the face is cheerful and peaceful.

Everyday the GROW team and I pass by the mural. Everyday we see the community concern for DV. When we visited the old police station, a poster hung on the wall about DV, last weekend when we visited a school to teach english, the class suddenly engaged in a conversation about DV in english, the other day the local news did a story on DV.

The old police station with the DV poster in the doorway.

The old police station with the DV poster in the doorway.

Last week there was a peace parade and festival for DV, and just today we saw a woman wearing a t-shirt with that read, “Law 779: Comprehensive law against violence towards women.” It is crazy how many ways, big and small, we see community acts against violence. The Siuna community REALLY cares about women, and they understand the magnitude of the problem.

The peace festival and parade in the center of Siuna

Thousands of people gathered in the heart of Siuna for the peace festival and parade. People wore shirts that said “Peace for Nicaragua” and “Stand Against Violence.”

Arriving in Siuna, I had low expectations of community support. Everyday I am pleasantly surprised at how wrong I was. I am so glad we have the people of Siuna backing us up on our project. If the community keeps up the awareness and energy, these women will continue to be empowered within Siuna. Knowing that this community is so wholeheartedly behind these women and efforts to support them has given us an unprecedented confidence in the community’s support for our project and its empowerment of women in the community.

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Shelter Update!

Over the past two days, we have begun our first work with the shelter fence! We woke up early in the morning on Friday to get to work, but things slowed a little bit when we had to stop to find fresh water. Once we got there, it was apparent to me and the rest of the team that we had picked a beautiful day to get started! One of the contractors was already there to get started with the demolition, which included ripping out the fence and barbed wire from the wooden posts in the fence.

At a glance, this job didn’t seem to be a challenge, but as we got started it was soon obvious that ripping out a fence was going to be tough work. However, with the help of the GROW team and the contractor we were able to bring down almost all of the barbed wire around the fence as well as much of the fence itself. As we tore down the fence, it became strikingly clear that this fence was in dire need of replacement. The vast majority of it was rusted through, and most of the posts either were rotted through or were home to massive termite nests. The new fence we will be putting in will have much sturdier concrete walls as well as razor wire instead of barbed wire.

After our work with the shelter we met up with Juan to get prices on furnishings for the shelter. We were mostly deciding between beds, tables, an oven, and a refrigerator. All in all, the furnishings will be taking a pretty small amount of our total funding, which when coupled with the cost of the fence, will mean we will have approximately $10,000 of GlobeMed money left over to spend on other aspects of the shelter!

On Friday, we started taking the posts in the fence out of the ground. If the work the day before had been difficult, this was just plain backbreaking. We had to dig out each post and either break the rotted wood from the ground or pull out the post altogether. Without the help of the contractor, we would not have gotten very far at all, but with his expertise and our backs we unearthed several of the monsters.

Later that day, we were visited by a crowd of kids off on a lunch break. We had met them a few days before when we stopped by to see them paint a mural as part of an extracurricular project that outlined the different sides of a woman’s life and her conflict with domestic violence.  These kids were 13 years old and already they were tackling one of the biggest social problems in the community! Wow. Even better, they stopped by the shelter to have a look themselves and see if they could help!

These past two days have certainly shown us just how much the community, especially the youth, support this project. At the same time, it has quickly become clear that in terms a construction a significant amount of work remains to be done with shelter. Even so, considering all that we have gotten done in just two days I am really hopeful that the shelter will be finished muy pronto! Though our team accomplished plenty in the past two days and will continue to get a lot of work done in the shelter in the coming week, the most important part of this process for me has been ensuring that construction has begun and will continue to run after we are gone.

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An Insightful Model for Our Future

This week we have been visiting Bilwi, the capital city of La RAAN, to meet with the Salud Sin Limités organization here and visit the women’s shelter to learn more details about how it functions, how many women usually stay in the shelter, the budget, the upkeep, programs offered, and any other information that could be relevant when designing and planning for our shelter in Siuna!  Also, Juan and Eliza attended a United Nations conference on the state of volunteerism in Nicaragua. Bilwi is about a 12-hour drive from Siuna. 12 hours in a bus on dirt roads complete with potholes, swerving to avoid the potholes, and 95 degree weather made for an interesting experience to say the least. Luckily, we made it out very much alive and with minimal casualties, only one puking incident and A LOT of dirt. By the time we arrived at the hotel, the word shower was pretty much synonymous with gift from God.

Our experiences today made the bus ride more than worth it. Dan, Phil, and I spent the morning meeting with Shira, the director of the shelter here sponsored by a program called Movimiento de Mujeres, or The Women’s Movement. She gave us a tour of the shelter and spoke with us about their organization, the types of services they offer, problems they’ve faced, and offered a few suggestions and important things to keep in mind during the early stages of the shelter in Siuna. The initial focus of the shelter here was offering legal assistance, psychological counseling, and medical services to women that have been victims of domestic violence. The external building offers these services for women who live in Bilwi and in neighboring communities. The internal building, which is the actual shelter, is for women who are using these services and have nowhere to stay. It’s located behind the external building, which offers more privacy, and has a kitchen, playroom, and three bedrooms. Over the past few years, the priorities of the shelter have changed to match the needs of the community. Now, the focus is on children and adolescents that have been victims of sexual abuse, unfortunately a common and widespread occurrence. Initially, women and their children were housed in the shelter but when the police came to the women’s movement with cases of young girls who had experienced sexual abuse in need of psychological care and a place to stay, the shelter opened its doors and is now home to mostly young girls, all victims of intrafamilial sexual abuse. Currently, there are 17 people total staying in the shelter, including one adult woman who brought her two daughters.


The most important takeaway from this meeting with regard to our project is how this shelter recognized the needs of the community and adapted in order to best suit the public. Because the situation of domestic violence in Siuna is very similar to the situation here in Bilwi, it is very possible that our shelter may need to eventually expand our focus and services offered to include adolescents and children who are victims of sexual abuse. It’s definitely something to keep in mind and share with Reina and Shellda when we return to Siuna.  However, a major difference between our project and the project in Bilwi is the support we are receiving from the government in Siuna. In Bilwi, the shelter receives no funding whatsoever from the government and has a difficult time working with the Ministry of the Family, a governmental organization responsible for ensuring protection and legal services. Luckily, as of right now the government will play a major role in funding our shelter. Shira also gave us a lot of advice for early planning of the shelter based off of her own learning experiences and trial and error during the development process. She was very knowledgeable about how to successfully maintain and oversee the function of a shelter and definitely a great contact for the future. Meeting with her gave us insight into what our project could hopefully become and also prepared us for some of the challenges we might face.

With everything we learned this morning combined with a chance to meet and play with the children staying in the shelter this afternoon, the trip to Bilwi has been memorable. It’s great to meet everyone involved in Salud Sin Limités and it was an important step in gathering information to maintain the shelter in Siuna and plan our future projects within the shelter! We are all very excited to return to Siuna, share what we’ve learned, and begin construction of the fence on Thursday.

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A Dream Come True

The first few days in Siuna have been incredibly exciting and informative. Today and yesterday we visited the site where the shelter is going to be, and met several members of the Commission for Women, Children, Adolescents, and the Disabled. We learned that the Commission is made up of 18 organizations including NGOs, government organizations, and universities, and all of them are involved with the shelter project.

Reina Flores, the president of the Commission and a human rights activist ever since the Sandinista Revolution, showed us the shelter site. It’s going to be built over an existing building, and will house twelve women initially. Reina showed us where the rooms are going to be, a meeting place, workshop rooms, laundry rooms, a kitchen, and two bathrooms. On Thursday, when we return from visiting the existing women’s shelter in Puerto Cabezas, we will be able to start helping to build the security gate around the outside.

Reina continually described the construction of the shelter as un sueño realizado – a dream come true.  She sees 10-15 women a day who come to her with reports of domestic violence seeking her help with their case, so she knows the huge scope of the problem, and she’s been hoping for the resources to do something about it for a long time. Salud Sin Limites and the Commission are starting the shelter this week with the money GlobeMed sent – our money will mostly go to building the security gate, redoing the roof which leaks, and buying materials such as beds for the women. In July they have been promised government support of USD $40,000 to finish the shelter and hope to open it up to women by the end of this year. Reina said that GlobeMed at Duke’s contribution to the shelter was essential in convincing the government that the project was worth supporting. This is amazing – our cupcake-selling and picture-taking and constant Facebook posting about Kaplan courses has actually paid off in such a huge way.

I wish I could be here to see the shelter completed, and am thinking about coming back to Siuna after I graduate to see the real difference that GlobeMed has made in the lives of women that suffer such horrific violence. I’m so proud to be part of GlobeMed, and I’m proud to be working with Salud Sin Limites and the Commission. I’ve been incredibly impressed with the initiative of everyone I’ve met here – Juan, his co-worker Shellda, Reina, all the other heads of NGOs that are working with the Commission – to see a problem in their community and organize themselves to fix it.

On Monday, we’ll be going to Puerto Cabezas, the capital of la R.A.A.N, to see the shelter that they have there, get ideas, and meet with development groups from the United Nations. Look out for more news soon!

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25 hours until GROW!

So we leave tomorrow for Siuna! In 25 hours, I will be getting on a plane. That is very soon. I’m pretty anxious but not in a bad way, more like I just want to be there already and skip all the travel time and start everything! I’m excited to meet Juan and get to know the community and Salud Sin Limites. A personal goal of mine for this trip is to stay open minded and realize that things aren’t going to go according to plan, and kind of just be ready for anything.  I also hope to improve my Spanish and learn as much as I can in three weeks about Nicaraguan culture and Siuna. Because of the global health elective class I took this past semester and a research paper I had to write on domestic violence in Nicaragua plus all the details we know from Juan, I feel like I do have a general idea of some of the cultural attitudes we will be encountering. From what we’ve learned, “machismo” is the role that a man must play as the protector or dominant force that is common throughout Latin America and unfortunately, is a factor that plays into the prevalence of domestic violence in Nicaragua. There are economic and political factors that serve as catalysts for domestic violence as well, such as widespread poverty and a history of political unrest and violence. I think it’s important to keep this background knowledge in mind while on the trip but with that being said, reading academic papers can only prepare you so much. Actually being there and immersing ourselves into the culture is going to be an entirely different ball game and unlike anything I’ve ever experienced!


For the project, our primary goal for GROW is getting to know the community in order to plan ways that the shelter and future projects can best meet their needs. More concretely, we will be getting to know Juan and the Nicaraguan government, visiting the university in Siuna, and neighboring villages with shelters to see how their programs work. I think we are also going to be buying materials for construction of the shelter and we may actually build the shelter depending on how quickly we can get the materials. I think the biggest thing for us besides doing whatever we can to further the progress of the actual shelter is to make sure we document everything really well so we can bring back as much knowledge as possible to Duke. Documentation of our experience through photos, videos, blog posts, and our own written journals is going to be really important to share with all of our GlobeMed staff so we can plan future projects and future GROW trips! I’m kind of worried about my Spanish skills and other minor stuff like making sure I have enough bug spray and sunscreen and snacks but I feel relatively calm about everything! Hoping not to have any nightmares from the malaria medication (“State of Wonder” scared me). Other than that, can’t wait! Wheels up from Philly on Tuesday and we’ll be in Siuna by Wednesday!


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My Goals: GROW 2013

I traveled to Central America a few years ago, but at this point I have a feeling GROW 2013 will be nothing like I have previously experienced. I have many expectations about the trip, some of which I’m sure will be fulfilled, while others may not be. We all have a plan coming into this; however, even the best plans can be subject to change. I suspect ours will change as we go there and work together with our partner community.  Regardless, I think my goals, as well as those of my colleagues Phil, Eliza, and Annie, are similar in that we all wish to make a positive impact on the community as well as change our own perspectives. However, our paths of development will be different from one another’s. For myself, I want to understand better the culture of the region in which we are working. Siuna is probably one of the most isolated places I will ever visit, and it’s hard to imagine how the social dynamics may differ between the U.S. and Siuna. Even with all of the knowledge and understanding that we have acquired through our contact with Juan, our previous GROW team, and just general research about the community, I feel like it is nearly impossible to comprehend beforehand what it will be like in the community and to predict what kind of experience we will have. Three weeks is a brief amount of time to spend anywhere, and not nearly enough time to be able to completely appreciate the value of a community like Siuna. That is why I want to make the most of the short time we will be spending there by learning as much about our partner community as I can.

At the same time, I want to strengthen our relationship with Siuna and our partner Salud Sin Limites by getting to know members of the community, employees of the Salud Sin Limites in Siuna and Bilwi, and maintaining contact with as many of them as we can. In addition, I think bringing back as much of the experience as we can to our chapter through our blog, media we bring back with us, and the stories we can tell. This is one of the most important parts of maintaining our chapter’s integrity which is why it is one of my highest priorities on GROW!

Finally, I want to do something that physically helps our project flourish. We are so lucky to have the project of constructing a shelter, as we can see the progress of it with our very own eyes. Besides that, we can make this project happen with our own hands. I think every one of us wants this shelter to be successful, and coming away feeling like I did something personally to help prepare it is a feeling that is invaluable to me and to my teammates as well I’m sure. This shelter is the crux of why we are coming to the community in the first place and though it may not be erected by the end of our time in Siuna, knowing that we have individually contributed to its completion means the world to me.

Only two days before we’re off!!


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